as I can, with my own hands (although this comes more and more to what can be done in the summer vacation) for this is what keeps me alive intellectually and is where I get my real fun. On the other hand, I feel that probably I accomplish most in the long run, not by protecting myself too closely, but by accepting as my major function that of helping my students and assistants. Much greater contributions to the advancement of medicine will come from the training of these men than through my own individual efforts. In all this lengthy letter I do not think I have once used the phrase “full-time” as applied to a clinic or a teacher. This is partly because I have become as tired of discussions of “full-time” teaching as I am of discussions of the Eighteenth Amendment, and partly because I do not think the issue is any longer of importance. There was a time when discussion of the system had a distinctly healthy effect on the teaching of medicine in America; but the whole situation is altered. A complete “full-time” system is impossible from an economic point of view, even if it were desirable medically, which I do not think it is. Experience has made it perfectly clear that the men who are in successful outside practice have something very definite and important to contribute to the teaching, and, as already indicated, they must be regarded as an integral part of the teaching service and receive proper recognition in the way of titles, salaries and clinical opportunities. I am, moreover, also convinced that it is not desirable to have any hard and fast rule as to the members of the hospital staff having private patients. For many, if not for all, it is desirable that they should have a few patients of their own, with whom they have the same relations that one does in outside practice. Occasional consultations, even outside the hospital, office practice and a few private patients in the hospital form the basis of a valuable experience for the teacher and investigator; but, of course, his other work will not allow him to assume the care of sick patients in their homes. There is no question in my own mind that I am a much better teacher for having had a limited number of such patients in recent years. These are the patients to whom I talk at length personally, and they are apt to be the cases that stick in my mind, so that I refer to them continually in talking to students. One can always say that the same thing may be done as well if the patients belong to the clinic and if, for instance, their fees are paid to the clinic; but I fear I do not agree to this. If they had been the patients of the clinic I should have had most of the work done by my assistants and I should have missed exactly that personal relationship with patients which many people say cannot be obtained in a hospital. If, however, I have been continually confronted with these personal relationships of practice, even though it be with few individuals at a time, it is much easier